CNA trouble.. again!? - page 2

So, I made a thread a week or so ago about getting CNAs to do their job. Well, tonight has really made me mad. A little background info for those who don't know... I'm 21.. a nurse of only 3... Read More

  1. by   CoffeeRTC
    Sooo....first you need to find out your facility's policy on this matter. It will be different if you have a union. Then you need to have whoever is in charge, be in charge. I, too, am gonna say that the CNA wasn't mad at you, but the system.
    What normally happens for us (CNA and LPNs are union) is that we do have mandatory OT only if ablsolutly needed to make the minimum staffing requirements. We have a list based on seniority and we need to ask them first. Then we have a mandation list and we keep track of who was last. Supposedly, if someone refuses or just walks off...they are fired. (its been done, but it doesn't always stick). As the RN, I would be the person to stay and work if the CNAs and LPNs absolutly refuse and of course this would be after calling and giving the DON heck for her not coming in. Its been years since this has happend.

    BTW...we do have a list of at least 10 agencies and our own pt staff, but just because they are there doesn't mean they will have a person at the last minute.

    Sounds like she left before the shift was over and without permission? That would be wrong and a write up or worse.
  2. by   lvlissl2ebecca
    Thank you all for your replies:

    In response to some of you, at my facility and in my state CNAs are held accountable for covering the floor. Someone MUST stay over if there is a call off (if we can't get anyone to come in, which we rarely ever do because no one answers the phone). The RN that I spoke with stated that this could be an abandonment issue. I worked there as a CNA before too and have been forced over. Its the way it goes at our facility. Usually, it is a take turns thing... if one CNA stays over tonight then she is exempt from staying over the next time and so on until a full rotation is made, but someone must stay, regardless.

    The thing is .. I understand that people have kids and issues that prevent them from staying over, BUT when it becomes a convienance thing, is when its a problem. This particular CNA never has to leave early unless there is a call off.. which is completely unfair to the rest of the CNAs that have to pick up the slack, especially when there is only one other eligible CNA.

    I, as a new nurse, am still learning my role as charge (although I was not charge this night) and did my best to keep the situation in control, but it failed.
  3. by   Cardiac-RN
    Quote from lvlissl2ebecca
    I, as a new nurse, am still learning my role as charge (although I was not charge this night) and did my best to keep the situation in control, but it failed.
    Sounds to me like whoever was in charge should have been the one to handle this situation, or that (for whatever reason the obligation landed on your shoulders) you should have involved someone higher up to help you deal with it properly instead of going out to smoke when there was an impending staffing situation still unresolved.
  4. by   Christie RN2006
    I also have been having issues with one of our aides (we call them PCAs) This one in particular is a bit odd, which I can deal with, but ever since she started she has forgotten at least one thing every night. Half the time I feel like I am orienting someone because I have to check her charting constantly and remind her to do things! Keep in mind I work in the ICU and there are only 10 beds total. I normally only have 2 patients and every night she forgets at least 1 foley. She either forgets to empty it or she forgets to chart how much there was. I have explained to her several times the need to get the numbers accurate and she always says that she understands, but then the next night it is always the same thing over again. Now she is starting to forget to do blood sugars too or doing them at the wrong time. I had someone on every hour blood sugars and she did them a half an hour early even though I explained the need to do them on the hour. I have gone to the NM with my concerns and she told me that they had talked to her about it. I don't want to get her fired or anything like that, but this has got to stop! I went as far as to pull her to the side and talk to her about how I know that sometimes it is easy to forget things and I was giving her hints on how to remember what needs done, but she ignored me and walked away. I know several other nurses have talked to her and our other PCAs have tried helping her too. Most of the nurses I work with won't even let her do things anymore other than helping clean people up.
  5. by   pepperann35
    :spin:I was wondering who the on-call supervisor was at the time? Don't you have anybody that handles these problems? Next time this happens, ask the cna's if they can stay over as soon as you know about the call-off. If nobody can, call your DON or whoever is on-call and let them handle it from there. Here in Florida, we cannot make anyone stay over. I went from being a cna to a nurse also, several years ago and worked in the same LTC. It is a transition to change roles, but you will be ok with time. Good luck to you!
  6. by   catlynLPN
    This is a problem common to just about all LTC's.
    The one I work at part time was going to be 2 CNA's short for night shift.
    One of the LPN's called the DON and the DON got mad at her for calling because a CNA had already called her.
    The DON told the LPN "Well, I can't do anything about it now." The LPN told her that if she was going to let the CNA's by pass the nurses and call her themselves then the CNAs need to inform the LPNs what they've done so she won't be called again.
    Apparently they've put the responsibility into the CNAs hands for calling the DON on staffing matters. They also never have a current schedule out where anyone can see if they've got a full staff coming or who is coming in.
    It's just horrible.
    So there ya go, administration doesn't care.
    This particular chain of nursing homes has a policy against calling registries for extra help, but they will suck up the fines from Office of Long Term Care for habitually being short staffed.
    They won't schedule over the minimum required, it's just always the minimum.
    So there's never any extra to take up the slack if someone calls in sick.
    This is a for profit facility. I noticed they were remodeling the front lobby and office a few days ago. Buying some new furniture and putting down marble floors.
    But some of the patients beds are broken and the handles to roll up are bent and won't roll the beds up. So you can't raise a patient up to take their medication.
    Siderails are broken, so they put the bed against the wall to use the wall for a siderail.
    Nightstands and closet drawers are broken and hanging out, unable to put it back it back in place, and some patients have no place to put their clothing due to drawers being broken.
    Half the time the kitchen doesn't send out enough snacks, sometimes none at all, and I've had to call and beg for HS snacks and get blessed out by a kitchen helper because I did so. He had gone home one night and didn't bring any snacks out so I called the dietary supervisor, and come to find out, HER SON was the one working in the kitchen and he was the one who didn't bring out the snacks.
    But let's make sure to pretty up the front office and lobby. Gotta keep it looking good ya know, to trick people into thinking this is a great place to place Mom and Dad in the golden years.
    I don't know why I stay there. I feel sorry for the patients, and have become quite attached to some of them and just can't stand it when they aren't treated right.
    But there's only so much I can do. Other than getting them their meds and something to eat at bedtime, there isn't much else I can do.

    Sorry for the long post and I didn't mean to get off the original subject but one thing just leads to another. I get so disgusted with this nursing home. I just want to scream, "Why can't you see how to do this right?"
    Last edit by catlynLPN on Nov 27, '07
  7. by   Plagueis
    Quote from lvlissl2ebecca
    Thank you all for your replies:

    In response to some of you, at my facility and in my state CNAs are held accountable for covering the floor. Someone MUST stay over if there is a call off (if we can't get anyone to come in, which we rarely ever do because no one answers the phone). The RN that I spoke with stated that this could be an abandonment issue. I worked there as a CNA before too and have been forced over. Its the way it goes at our facility. Usually, it is a take turns thing... if one CNA stays over tonight then she is exempt from staying over the next time and so on until a full rotation is made, but someone must stay, regardless.
    I am curious as to exactly what state and state law specifies that CNAs are not allowed to leave work after their shift is over, if they didn't sign up for overtime. I've heard of mandatory overtime, but I never heard of it when related specifically to CNAs. If a CNA agreed to work a shift, or agreed to stay, but backed out, then that could be considered abandonment. However, if someone doesn't want to stay for next shift because of exhaustion or child care issues, for instance, then I don't see how that is abandonment. Of course, I'm not a lawyer, but if it is supposedly "illegal" for CNAs to leave work when someone from the next shift doesn't show up, then are those CNAs arrested and charged with a crime? It is the responsibility of the facility to ensure proper staffing, and this should include overstaffing in case of call outs or call ins. Why don't many workplaces get this?
  8. by   Duflinkka
    An on call team would be fantastic. That is totally impossible, though. Staffing is such an issue here, as I'm sure it is everywhere. In our facility they make the schedule out with blanks for people to sign in because we are so short. Nurses regularly fill in the blank spots on the schedules and work as CNA's so we aren't too short. We always have ads in the paper, we offer decent hiring bonuses, and we are one of the top paying facilities in town. The problem is aides know there is such a shortage they can bounce from facility to facility if they don't get what they want or feel slighted in any way.

    I'm speaking from experience - that is exactly what I heard from aides I worked with before I got my LPN. And that is exactly what I see at work now. I'm just very grateful for the staff we have now.
  9. by   lookingbeyond
    Quote from Sweet Pea 1
    Casi, the facility you worked at may have said that they had mandatory overtime but with the labor laws out there they can not force you to work over your 40 hrs a week. If a facilty needs someone that bad and no CNA can stay maybe a nurse should stay. I am not a nurse yet but think that it is the nurses responsibility to make sure that there is coverage. I have work at many LTC facilities and have seen nurses work as CNA's when there was noone else.
    Wow, I work a LTC facility that requires mandatory overtime if needed...Hmmmm. Then, wonder why the CNA's are so grouchy.

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